NPI | 1548728058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208800000X Urology (Licence: NY 312738) |
Additional Taxonomies | 208800000X Urology (Licence: NJ 25MA11722700) |
Enumeration Date | 2019-03-05 |
Last Update Date | 2024-05-28 |